SOL-MILLENNIUM
Received May 16, 2025 · Event occurred Nov 22, 2024
Report 3014312726-2024-00364 · MDR key 22035645
Device
Generic name
Sol-m 1ml Luer Lock Syringe W/o Needle
Manufacturer
Sol-millennium Medical IncModel number
P180001PPLot number
08104003
Product problems
- Crack
- Crack
Patient
NA · Unknown
- No Clinical Signs, Symptoms or Conditions
- No Clinical Signs, Symptoms or Conditions
Narrative
Additional Manufacturer Narrative
THERE IS NO EVIDENCE OF QUALITY ISSUES ASSOCIATED WITH THIS COMPLAINT BASED ON THE ARCHIVE SAMPLE ANALYSIS. BASED ON THE DETERMINED RISK PRIORITY NUMBER, THE RESIDUAL RISK RELATED TO THE COMPLAINT IS CONSIDERED ACCEPTABLE. SOL MILLENNIUM CONTINUES TO MONITOR THIS KIND OF ISSUE. ADDITIONAL ASSESSMENT WILL BE TAKEN IF A SIGNIFICANT PATTERN EMERGES. UNCONFIRMED. THIS REPORT WAS INITIALLY SUBMITTED ON 12/06/2024. DUE TO ISSUES WITH DISPLAYING THE INITIAL SUBMISSION, THIS SUBMISSION CONTAINS BOTH INITIAL AND SUPPLEMENTAL INFORMATION
Description of Event or Problem
"CUSTOMER REPORTED PT CAME FOR MODERNA COVID INJECTION TONIGHT. AS I WAS INJECTING THE VACCINE INTO THE PT., THE NEEDLE WAS IN THE PTS DELTOID MUSCLE CORRECTLY, WHEN I STARTED TO PRESS ON THE SYRINGE. THEN THE HUB OF THE SYRINGE SPRAYED OUTWARD THE VACCINE, SPRAYING THE PTS WIFE AND MYSELF. THE PT DID NOT GET THE VACCINE. THE NEEDLE POINT WAS REMOVED FROM THE PT., AND COTTON BALL APPLIED TO THE SITE. A SECOND SHOT WAS GIVEN TO THE PT., AS HE ACCEPTED THE SYRINGE WAS DEFECTIVE. PT DID NOT SUFFER ANY PAIN OR DISCOMFORT, ONLY THE FACT OF HAVING A SECOND COVID VACCINATION. THIS WAS FINE ACCORDING TO THE PT. AND CHARTED AS SUCH. ON INSPECTION AFTERWARDS, THE HUB OF THE 1 CC SINGLE USE SYRINGE HAD A CRACK IN IT AND WAS DEEMED DEFECTIVE. "
Additional Manufacturer Narrative
THIS REPORT WHEN INITIALLY SUBMITTED ENCOUNTERED AN INTERNAL ISSUE POTENTIALLY RELATED TO DATABASE CONNECTIVITY. THIS ISSUE WAS IDENTIFIED WHILE IMPLEMENTING CAPA-57 WHICH WAS OPENED FOLLOWING AN FDA INSPECTION.